Monkeypox Cases Climb In MD As Testing, Vaccinations Limited: Hogan

ANNAPOLIS, MD — Monkeypox cases are rising in Maryland, leading Gov. Larry Hogan and the Maryland Department of Health to outline the state's response to the outbreak, including plans to make testing, vaccination, and public health resources available for high-risk populations.

The World Health Organization has declared a global health emergency, and governments are asking for more vaccines to prevent the rare but serious illness predominantly caused by prolonged intimate physical contact. In May 2022, several clusters of human monkeypox cases were reported in countries that do not normally report human monkeypox, including the United States.

Maryland’s first monkeypox case was announced on June 16, according to Hogan's office. While anyone can get and spread monkeypox, the vast majority of cases have been reported among men who have sex with men.

“While vaccine supply from the federal government is severely limited at this time, anyone who believes that they may need testing or treatment should contact their healthcare provider or local health department immediately,” Hogan said in a news release Tuesday. "We will keep pressing the federal government to provide more vaccines to the states and do all we can to make resources available to those at risk.”

Health workers want to limit the spread of the virus and vaccinate anyone who may have been exposed in the previous two weeks, said MDH Deputy Secretary for Public Health Services Dr. Jinlene Chan, in the statement on the human monkeypox outbreak.

“Due to the limited supply of the vaccine from the federal government, the state is working closely with local health partners to make doses available in a manner that focuses on locations that have case counts and higher-risk populations," Chan said. "We plan to expand access to the vaccine as more supply becomes available.”

Monkeypox has been reported in all 50 states, the District of Columbia and Puerto Rico. In Maryland, there have been 129 lab-confirmed cases of monkeypox on Tuesday, the U.S. Centers for Disease Control and Prevention said.

The Maryland cases represent 2.2 percent of monkeypox cases nationwide. At present, the majority of cases have been reported in the National Capital Region, Hogan's office said.

New York has the most monkeypox cases in the country with 1,390, followed by 827 in California and 520 in Illinois.

MD's Monkeypox Testing, Vaccination Plan

Testing Capacity. Testing for monkeypox is available through commercial labs and the MDH state public health laboratory. It is not available to purchase at stores. Resident who believe they were exposed to monkeypox or have an illness that could be monkeypox should contact their medical provider. People without a provider or insurance should visit health.maryland.gov/CSTIP/local to find contact information for their local health department. Healthcare providers should educate patients on home isolation while results are pending.

Vaccination Plan. To date, the federal government has allocated to MDH enough doses to vaccinate 3,202 patients with the two-dose Jynneos vaccine. Vaccine supply from the federal government remains limited, and additional supply may not be available until the fall. Based on CDC guidelines, state and local health officials are prioritizing vaccination courses for:

• Public Health Identified Close Contacts: Known close contacts who are identified by public health via case investigation, contact tracing, and risk exposure assessments.
• Occupational Exposure: Healthcare workers who may have been exposed to a known case and Laboratory Response Network or other laboratory staff working directly with monkeypox testing.

In addition, state and local health officials will follow CDC guidelines to make vaccines available to these people based on supply:

• Self-Identified Partners of Cases: Individuals who are aware that one of their sexual partners from the past two weeks has been diagnosed with monkeypox.
• Affected Community Members: Those in high-risk populations who report any of the following in the past two weeks:
  • Recent group sex or sex with multiple partners.
  • Sex or employment at a venue or in association with an event, venue, or defined geographic area where monkeypox transmission has been reported.

Contact Tracing. Contact tracing is being conducted by state and local health departments for all presumed monkeypox cases. Individuals identified as having close contact with case-patients have been offered vaccination through their local health department, in accordance with CDC guidelines.

Public Outreach and Awareness. State health officials continue to conduct direct outreach to clinicians and regularly brief local health officers. A listening session for interested residents has been held as well. MDH has also made available a fact sheet and frequently asked questions with information about human monkeypox. Earlier this week, the CDC released updated guidance on isolation and prevention practices.

The monkeypox virus has rarely been reported outside of Central and West Africa, where host animals include a range of rodents and monkeys. It can be easily spread from animals to humans through a bite or scratch, according to the WHO. The last time the United States saw a sizable outbreak was in 2003, when 70 cases were linked to the import of infected prairie dogs.

• Related: What Is Monkeypox?

"The bottom line is we've seen a shift in the epidemiology of monkeypox where there's now widespread, unexpected transmission," Dr. Albert Ko, a professor of public health and epidemiology at Yale University, told The Associated Press. "There are some genetic mutations in the virus that suggest why that may be happening, but we do need a globally-coordinated response to get it under control."

Ko called for more testing to shore up gaps in surveillance to get a better picture of monkeypox in the United States. Health officials have expanded monkeypox testing and plan to release another 1.6 million doses of the vaccine in the coming months.

"The cases we are seeing are just the tip of the iceberg," Ko told the AP. "The window has probably closed for us to quickly stop the outbreaks in Europe and the U.S., but it's not too late to stop monkeypox from causing huge damage to poorer countries without the resources to handle it."

UCLA epidemiologist Anne Rimoin, who has studied monkeypox for decades, told NPR the United States is "losing daylight" in its response to monkeypox. "Every day that we aren't continuing to push forward on all fronts, the less likely it is that we will be able to contain it," Rimoin said.

The Associated Press contributed reporting.